文章：

头颈部临床淋巴结阴性皮肤鳞状细胞癌区域淋巴结处理策略：一项系统综述与荟萃分析

Management of Regional Lymph Nodes in Clinically Node-Negative Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic Review & Meta-Analysis

原文发布日期：16 October 2025

DOI: 10.3390/cancers17203335

类型: Article

开放获取: 是

英文摘要：

Background/Objectives: Head and neck cutaneous squamous cell carcinoma (HNcSCC) has the potential to metastasize to local lymph nodes, which can significantly impact prognosis. However, the optimal management of patients with clinically node-negative (cN0) disease remains unclear. Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, Scopus, CINAHL, and Web of Science databases were searched from inception to 7 August 2025. Two parallel searches were conducted: one to capture management strategies and outcomes of cN0 patients with HNcSCC and one to capture occult nodal metastasis rates of the same population. Results: A total of 38 studies were included. Post-excision management strategies included observation, sentinel lymph node biopsy (SLNB), elective dissection (ED), and elective nodal irradiation. The pooled rate of occult lymph node metastasis was 13.9% in 1673 HNcSCC tumors overall and 12.5% when limited to 977 high-risk tumors. Overall recurrence in the SLNB group (8.3%) was significantly lower than both the observation (16.9%,p< 0.0001) and ED (23.7%,p< 0.0001) groups. Additionally, overall mortality in the SLNB group (6.1%) was significantly lower than observation (29.9%,p< 0.0001) and ED (31.4%,p< 0.0001). Conclusions: We found that SLNB was associated with lower recurrence and mortality compared with observation and ED. While not assumed to be causative, our findings support the role of SLNB in diagnosing occult metastasis and staging disease in this population.

摘要翻译： 

背景/目的：头颈部皮肤鳞状细胞癌（HNcSCC）具有转移至局部淋巴结的潜力，这可能显著影响患者预后。然而，对于临床淋巴结阴性（cN0）患者的最佳管理策略仍不明确。方法：我们按照PRISMA指南进行了系统性综述与荟萃分析。检索了自建库至2025年8月7日期间PubMed、Scopus、CINAHL和Web of Science数据库。研究进行了两项平行检索：一项旨在获取cN0期HNcSCC患者的管理策略与结局，另一项旨在获取同一人群的隐匿性淋巴结转移率。结果：共纳入38项研究。切除后的管理策略包括观察、前哨淋巴结活检（SLNB）、择区性淋巴结清扫（ED）以及择区性淋巴结放疗。在总计1673例HNcSCC肿瘤中，隐匿性淋巴结转移的汇总发生率为13.9%；当仅限于977例高风险肿瘤时，该比率为12.5%。SLNB组的总体复发率（8.3%）显著低于观察组（16.9%，p < 0.0001）和ED组（23.7%，p < 0.0001）。此外，SLNB组的总体死亡率（6.1%）也显著低于观察组（29.9%，p < 0.0001）和ED组（31.4%，p < 0.0001）。结论：我们发现，与观察和ED相比，SLNB与更低的复发率和死亡率相关。虽然不能直接推断为因果关系，但我们的研究结果支持SLNB在该人群中用于诊断隐匿性转移和疾病分期的作用。

原文链接：

Management of Regional Lymph Nodes in Clinically Node-Negative Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Systematic Review & Meta-Analysis